Fergus MacSweeney1, Alan Darby, Asif Saifuddin. 1. Department of Histopathology, The Royal National Orthopaedic Hospital NHS Trust, Brockley Hill, Stanmore, Middlesex, HA7 4LP, UK.
Abstract
OBJECTIVE: To correlate the T2-weighted and STIR MRI appearances of dedifferentiated appendicular chondrosarcoma with gross and microscopic pathology. DESIGN AND PATIENTS: Nine patients with a histologically confirmed diagnosis of dedifferentiated appendicular chondrosarcoma were identified from the Bone Tumour Registry. All patients underwent MRI, including T2-weighted and/or STIR sequences in at least one plane, prior to limb salvage surgery. Areas of reduced signal intensity (SI) compared with hyperintense chondral tumour on the T2-weighted or STIR images were correlated with the resection specimen, to determine the relationship of such out areas of reduced SI with regions of dedifferentiation. RESULTS AND CONCLUSIONS: Patients presented over a period of 7 years. There were five men and four women with mean age 68.2 years and age range 51-78 years. Tumours arose in the femur (6 cases), humerus (2 cases) and tibia (1 case). Three MRI patterns were identified: (1) type 1, a lesion with two distinct signal characteristics-hyperintense chondral and reduced SI dedifferentiated tumour (n=6); type 2, mainly reduced SI lesion-dedifferentiated tumour, with areas of signal void corresponding to matrix calcification (n=2); type 3, a heterogeneous lesion with no radiological evidence of underlying chondral tumour (n=1). T2-weighted or STIR MR sequences can identify areas of dedifferentiation, which should be the preferential site of pre-operative biopsy.
OBJECTIVE: To correlate the T2-weighted and STIR MRI appearances of dedifferentiated appendicular chondrosarcoma with gross and microscopic pathology. DESIGN AND PATIENTS: Nine patients with a histologically confirmed diagnosis of dedifferentiated appendicular chondrosarcoma were identified from the Bone Tumour Registry. All patients underwent MRI, including T2-weighted and/or STIR sequences in at least one plane, prior to limb salvage surgery. Areas of reduced signal intensity (SI) compared with hyperintense chondral tumour on the T2-weighted or STIR images were correlated with the resection specimen, to determine the relationship of such out areas of reduced SI with regions of dedifferentiation. RESULTS AND CONCLUSIONS:Patients presented over a period of 7 years. There were five men and four women with mean age 68.2 years and age range 51-78 years. Tumours arose in the femur (6 cases), humerus (2 cases) and tibia (1 case). Three MRI patterns were identified: (1) type 1, a lesion with two distinct signal characteristics-hyperintense chondral and reduced SI dedifferentiated tumour (n=6); type 2, mainly reduced SI lesion-dedifferentiated tumour, with areas of signal void corresponding to matrix calcification (n=2); type 3, a heterogeneous lesion with no radiological evidence of underlying chondral tumour (n=1). T2-weighted or STIR MR sequences can identify areas of dedifferentiation, which should be the preferential site of pre-operative biopsy.
Authors: R Capanna; F Bertoni; G Bettelli; P Picci; P Bacchini; D Present; A Giunti; M Campanacci Journal: J Bone Joint Surg Am Date: 1988-01 Impact factor: 5.284
Authors: Claudia Deckers; Maarten J Steyvers; Gerjon Hannink; H W Bart Schreuder; Jacky W J de Rooy; Ingrid C M Van Der Geest Journal: Acta Orthop Date: 2020-05-20 Impact factor: 3.717